How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $28.18 Typical High $34.67 | Professional | None | $23.44 | $28.18 | $34.67 |
Regence BlueShield Setting Professional Modifier None Typical Low $26.30 Median $27.54 Typical High $42.66 | Professional | None | $26.30 | $27.54 | $42.66 |
Select Health Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Select Health Setting Professional Modifier None Typical Low $23.44 Median $28.84 Typical High $45.71 | Professional | None | $23.44 | $28.84 | $45.71 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $18.20 Median $37.15 Typical High $60.26 | Professional | None | $18.20 | $37.15 | $60.26 |
United Setting Professional Modifier None Typical Low $16.22 Median $25.12 Typical High $40.74 | Professional | None | $16.22 | $25.12 | $40.74 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.13 Median $8.13 Typical High $11.22 | Professional | 52 · Reduced service | $8.13 | $8.13 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $4.47 | Professional | 53 · Discontinued | $3.24 | $3.24 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $3.39 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $2.24 |
Where Utah sits
The same service costs 4.1 times more in Wyoming than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Utah· 25th of 51
$27.54
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.